by Andreia Biolo, Sujata Ramamurthy, Lawreen H. Connors, Carl J

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Matrix Metalloproteinases and Their Tissue Inhibitors in Cardiac AmyloidosisCLINICAL PERSPECTIVE by Andreia Biolo, Sujata Ramamurthy, Lawreen H. Connors, Carl J. O'Hara, Hans K. Meier-Ewert, Pamela T. Soo Hoo, Douglas B. Sawyer, David S. Seldin, and Flora Sam Circ Heart Fail Volume 1(4):249-257 November 1, 2008 Copyright © American Heart Association, Inc. All rights reserved.

Figure 1. BNP and the ECM proteolytic marker profile in cardiac and noncardiac amyloidosis. Figure 1. BNP and the ECM proteolytic marker profile in cardiac and noncardiac amyloidosis. A, BNP; B, TIMP-1; C, MMP-9; D, TIMP-2; E, TIMP-4; F, MMP-2. *P=0.01 versus AL-renal; †P<0.01 versus SSA-ATTR; **P<0.05 versus AL-renal; ‡P<0.05 versus SSA-ATTR. Andreia Biolo et al. Circ Heart Fail. 2008;1:249-257 Copyright © American Heart Association, Inc. All rights reserved.

Figure 2. The relationship between BNP and MMP-9 (A), TIMP-1 (B), MMP-2 (C), and MMP-9/TIMP-1 (D). Figure 2. The relationship between BNP and MMP-9 (A), TIMP-1 (B), MMP-2 (C), and MMP-9/TIMP-1 (D). Closed squares indicate AL-CMP; open squares, SSA-ATTR group. Andreia Biolo et al. Circ Heart Fail. 2008;1:249-257 Copyright © American Heart Association, Inc. All rights reserved.

Figure 3. The relationship between tissue Doppler e′ and BNP (A), TIMP-1 (B), and MMP-9 (C). Figure 3. The relationship between tissue Doppler e′ and BNP (A), TIMP-1 (B), and MMP-9 (C). Closed squares indicate AL-CMP; open squares, SSA-ATTR group. Andreia Biolo et al. Circ Heart Fail. 2008;1:249-257 Copyright © American Heart Association, Inc. All rights reserved.

Figure 4. Immunohistochemical analyses of MMP-9 and TIMP-1 in amyloidotic endomyocardial biopsy. Figure 4. Immunohistochemical analyses of MMP-9 and TIMP-1 in amyloidotic endomyocardial biopsy. A, There is no MMP-9 staining in the normal, nonamyloid heart. MMP-9 expression is more diffuse in AL-CMP than SSA heart biopsies. Solid blue arrows indicate amorphous amyloid deposition in the ECM. (Magnification ×100.) B, MMP-9 expression in AL-CMP and SSA heart biopsies. Solid black arrows indicate staining in cardiomyocytes; dashed back arrows, MMP-9 staining in the interstitium; red arrows, MMP-9 expression in (+) control; blue arrows, amyloid deposits in the ECM. (Magnification ×400.) C, TIMP-1 expression is more diffuse in AL-CMP than SSA heart biopsies. Solid arrows indicate TIMP-1 staining in cardiomyocytes; dashed arrows, TIMP-1 staining in the interstitium; red arrows, TIMP-1 expression in (+) control; blue arrows, amyloid deposition in the ECM. (Magnification ×400.)‏ Andreia Biolo et al. Circ Heart Fail. 2008;1:249-257 Copyright © American Heart Association, Inc. All rights reserved.